A naturalistic comparison of the efficacy and safety of intramuscular olanzapine and intramuscular haloperidol in agitated elderly patients with schizophrenia

Abstract

Objective: This study was a comparative investigation of the clinical efficacy and safety of intramuscular (IM) olanzapine and IM haloperidol in agitated elderly patients with schizophrenia at 2 hours postdose. Methods: The subjects were 23 inpatients who had been diagnosed with schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Their clinical symptoms were assessed using Positive and Negative Syndrome Scale Excited Component (PANSS-EC), PANSS and Agitation Calmness Evaluation Scale (ACES), and their safety were assessed using the Abnormal Involuntary Movement Scale (AIMS), Barnes Akathisia Rating Scale (BARS), Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS) and laboratory tests. Results: The mean reduction from baseline on the PANSS-EC total score, the PANSS total score and the ACES score were significantly greater in the IM olanzapine injection group than in the IM haloperidol injection group. The mean changes from baseline on the AIMS score, the BARS score and the DIEPSS total score were significantly better in the IM olanzapine injection group than in the IM haloperidol injection group. No serious adverse events such as paralytic ileus, diabetic ketoacidosis, neuroleptic malignant syndrome or tardive dyskinesia occurred between the two groups. Conclusion:The results of this study suggest the possibility that agitated elderly patients may result in superior efficacy and safety after IM olanzapine without serious adverse events in comparison with IM haloperidol.

Safety and effectiveness of rapid-acting intramuscular olanzapine for agitation associated with schizophrenia – Japan postmarketing surveillance study

“…Previous clinical trials reported a significant improvement from baseline in PANSS-EC scores 2 hours after IM olanzapine. 17 , 28 , 30 Similar results were seen in this PMS study, where there was an improvement in the PANSS-EC total score and in all 5 subitems when comparing changes from baseline to 2 hours after the IM olanzapine injection.…”

Effectiveness and safety of oral olanzapine treatment transitioned from rapid-acting intramuscular olanzapine for agitation associated with schizophrenia

“…Previous studies have reported an improvement in PANSS-EC scores after treatment of acute agitation with intramuscular olanzapine 10 , 11 , 19 , 20 and after treatment with oral olanzapine. 20 Our report showed that acute agitation can improve as early as 2 hours after treatment with RAIM, and this improvement was maintained for 7 days after administration of RAIM in patients who transitioned to oral olanzapine.…”

Cost Analysis of Antipsychotics Schizophrenia of Inpatients in Mental Hospital West Java Province

“…Characteristics of schizophrenia in the acute stage are that the patient is often restless, irritable, and sometimes shows hostility and violence. In such cases, the patient must be treated immediately to minimize the risk to others or self (Suzuki et al, 2013). The prevalence of schizophrenia in Indonesia in 2018 with the highest rates in Bali (11.1%), DI Yogyakarta (10.4%), NTB (9.6%), West Sumatra (9.1%) and Central Sulawesi (8, 2%) (Ministry of Health RI.…”